[Changes in the small and large intestines in systemic sclerosis].
A series of 21 subjects (2 males and 19 females) affected with systemic sclerosis, was examined by small bowel (oral and intubation methods) and colon enema. The underlying process responsible for abnormalities in the small bowel and colon in systemic sclerosis is a variable and pacthy destruction of the muscularis propria, that produces the structural and functional changes detected on X-ray. Pathologic condition is the same affecting the esophagus. The scout film of the abdomen often reveals colonic distension and fecal impaction, so that it may be quite difficult to prepare adequately the patients for a barium enema. Peristalsis may be virtually absent in short segments, and transit time may be several time longer than that in normal patients. For these reasons, intestinal pseudo-obstruction may appear in systemic sclerosis. The observed radiographic changes are: 1) in the small bowel: a) dilatation of the gut, especially in its proximal portions (duodenum and jejunum), in which the valvulae conniventes are straightened, normal or thinned; b) presence of diverticula, 2-4 cm in diameter, with hemispherical shape without the neck-like opening into the bowel lumen; 2) in the colon, the characteristic finding is an increase in size of individual haustra, forming sacculations or pseudo-diverticula, usually on the antemesenteric border of the transverse colon, better demonstrated on post-evacuation film. Moreover, loss of colonic haustration is also observed associated to colonic elongation and dilatation.
Scutellari
P N
PN
Istituto di Radiologia, Università, Ferrara.
Cinotti
A
A
Orzincolo
C
C
Cavallari
L
L
Dovigo
L
L
Menegale
G
G
Trotta
F
F
D000328:Adult; D000368:Aged; D003108:Colonic Diseases / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000000981:diagnostic imaging; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012595:Scleroderma, Systemic / Q000000981:diagnostic imaging*
Alterazioni dell'intestino tenue e crasso nella sclerosi sistemica.